- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,626.00 / $12,693.00 / $21,789.60
| Facility | | $5,626.00 | $12,693.00 | $21,789.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,145.87 / $22,441.80 / $30,235.49
| Facility | | $15,145.87 | $22,441.80 | $30,235.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,030.95 / $17,740.63 / $28,365.39
| Facility | | $14,030.95 | $17,740.63 | $28,365.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,946.17 / $19,111.81 / $40,078.08
| Facility | | $9,946.17 | $19,111.81 | $40,078.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,107.16 / $7,539.89 / $7,808.87
| Facility | | $7,107.16 | $7,539.89 | $7,808.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,030.95 / $18,985.61 / $28,372.39
| Facility | | $14,030.95 | $18,985.61 | $28,372.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $15,806.00 / $24,402.02
| Facility | | $4,870.00 | $15,806.00 | $24,402.02 |